I’ve been reading 100 Questions & Answers about Your Child’s Asthma by Claudia Plottel, MD and B Robert Feldman, MD. (Full disclosure: Dr Feldman was my pediatric allergist and is a relative).
The book is an excellent primer for parents of newly diagnosed children with asthma. An estimated 6.5 million children in the US are affected by asthma. However, I’d recommend this book for anyone with asthma, either newly diagnosed or those of us who have lived with asthma for many years. Anyone with a long-term chronic disease like asthma can always learn more about what asthma is, how it’s caused, how it’s diagnosed, how it affects the body and how it’s treatable at any age.
There are two new things that I learned that I wanted to share.
Asthma is not a psychological disease
Asthma and allergies have been classified as internalizing disorders in the past, i.e. disease caused, or at least exacerbated, by psychological distress especially in childhood. Plottel and Feldman dispel that myth early in their book.
“Asthma is definitely not a psychological disease; it is a physical condition that affects the lungs and bronchial passages. The concept that asthma is somehow an emotional disturbance is a myth.” They continue to describe how as asthma is a frightening experience. Fear and panic can be a response to an attack; but they remind us, they are not the cause.
This is was a very important myth to dispel. By calling asthma and allergies a psychologically-based disease, it somehow implied that it is under the control of the one who has the disease, e.g if they could just handle their problems better, they wouldn’t be sick. It a crucial distinction for anyone with allergies and asthma to understand: they didn’t cause their disease.
Asthma is caused by inflammation
Plottel and Feldman give a brief history lesson about asthma. Did you know that they were writing about cures for asthma in 1550 BC? Historical views on asthma focused on bronchoconstriction or airway narrowing. Traditionally, asthma treatments were based on opening airways and treating attack symptoms rather than on longer-term, preventative measures. The contemporary perspective includes bronchoconstriction but places greater emphasis on inflammation.
Inflammation is defined by the authors as: “A physiological process that plays a very important role in asthma. Inflammation occurs as consequence of the release of chemicals called inflammatory mediators from specialized white blood cells. The release of these chemicals, which occurs most often as the result of an allergic reaction, has the potential to cause chronic changes with the tissue of organs such as the lung. Over time, inflammation has the potential to damage organs, thereby making them less capable of performing their normal functions.”
The new focus on asthma as a result of inflammation directs doctors to prescribe medications that seek to decrease the inflammation long-term – preventating measures versus treating acute cases on an individual basis. The central idea and the new thinking about asthma is that by successfully controlling inflammation and remaining alert to early symptoms of acute asthma, “attacks” can be avoided and one’s life can be less interrupted or restricted.